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Epidemiology

Poster Session 4

(934) Long-term childhood outcomes after pregnancy complicated by isolated polyhydramnios

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: While most cases of polyhydramnios are mild and of unknown etiology, some cases are indicative of underlying congenital anomalies or genetic syndromes. Antenatal counseling is compounded by the lack of long-term outcomes from children born after isolated polyhydramnios.

Study Design: We performed a case-control study utilizing a blended database of linked pregnancy-to-pediatric medical records and insurance claims from 2014-2022 from a multi-state health insurance and delivery organization. Propensity score (PS) matching was performed based upon sex of the infant, the mothers’ comorbidities (Charlson comorbidity index), and number of months of follow-up. Cases and controls were matched with replacement with a 1:1 ratio with preference given to exact matches. We excluded patients with diabetes. The primary exposure was isolated polyhydramnios. Long-term outcomes include fetal death, PICU admission, neurologic diagnosis, developmental delay, and therapy (speech, occupational, or physical). Demographics and individual outcomes were analyzed using Chi-squared tests, whereas the composite outcome was examined with Poisson regression.

Results: From a total population of approximately 5 million individuals, we identified 3,182 pregnancies complicated by polyhydramnios. These were PS matched to 2,955 control pregnancies. There were no significant demographic differences between groups. Individually, polyhydramnios was a significant risk factor for PICU admission (2.7% vs 1.6%, OR 1.7 [95% CI 1.2-2.5]) and developmental delay (9.6% vs 8.0%, OR 1.2 [95% CI 1-1.5]). No other measured adverse outcomes were different. Polyhydramnios was significantly associated with increased rates of any adverse outcome as well as two adverse outcomes and three or more (see Figure 1).

Conclusion: Long-term childhood outcomes are higher for polyhydramnios-complicated pregnancies. Future research should study this association and the effects of polyhydramnios severity and prematurity on outcomes.